Considering breast augmentation but I'm a PE survivor. How risky is it to undergo such surgery?

one and a half years ago, I had bi lateral pulmonary embolisms. It was determined to be ideopathic but I was on the birth control pill at the time. I am 5'6 130 athletic (cyclist and weight lifter) and a non smoker. I am interested in a breast augmentation. I do plan on seeing a heamotologist to rule out any clotting disorders. How risky is it to undergo such surgery? Are there things that I can do post op to decrease clotting risks?

Doctor Answers 16

Breasts augmentation with PE history

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Dear  athletic Canadian,
  It is impossible to answer your question without more data. If indeed, your PE was a fluke and you do not have genetic abnormalities of the clotting cascade, based on evaluation by hematologist , than you can proceed with your breasts augmentation desire.
       Low dose Lovenox,  immediately after surgery can be a good safety measure to reduce the likelihood  of blood clots , since after all , you are considered high risk person due to your PE history. 
  Good hydration and ambulation after surgery,  are also very helpful in reducing the chance of developing blood clots.
  Most importantly, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. You should be seen frequently by your surgeon after surgery and with any signs of unilateral swelling of one of your your legs or shortness of breath, call your surgeon or head to the closest emergency room.
                     Best of luck,
                                        Dr Widder

See a hematologist

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Thank you for the question.  Yes, you should be able to have breast augmentation surgery but it would be best to contact your hematologist first in order to make sure you don't have any blood clotting issues.  Best of luck, Dr. Michael Omidi.  

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 122 reviews

I'm a PE survivor, can i have a breast augmentation?

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Thank you for your excellent question and I am glad that you are doing well after such a lift-threatening condition.  I would strongly recommend seeing a hematologist first and foremost.  Based on any testing for clotting disorders, the appropriate treatment regimen before and after surgery can be instituted to minimize your risks with surgery.  This may involve blood thinning medications before and after, but may also entail easier prevention methods, such as an oral aspirin, early and frequent walking after surgery, and lower leg compression devices during surgery.  Talk to your ASPS board certified plastic surgeon about your clotting history. They will be able to work with your hematologist to arrive at the best plan. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Considering breast augmentation but I'm a PE survivor. How risky is it to undergo such surgery?

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Thanks for your question,

I am glad to hear that you are in good health following you health issues.

If you are considering a breast augmentation it is important to have a consultation with a board certified plastic surgeon, at the time of your consultation be sure to voice all of your past medical history and any concerns that you have. If the surgeon you have consulted with feels you are a good candidate and it is safe for you to proceed with surgery please ensure that you have a full work up done prior to surgery including blood work and other medical testing they suggest.

It is also a great idea to seek out an assessment from your hematologist prior to surgery to ensure that it is safe for you to proceed.

All the best,

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Pulmonary embolism risk in Breast Augmentation

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In a person without risk factors breast augmentation should be no more risky then the car ride to the surgery center.  Breast augmentation is a relatively fast operation so time spent on the operating table is short.  This is in distinction for example to a tummy tuck combined with a breast procedure.  More time and tightening of the abdominal cavity increase risk of pulmonary embolism.

You are right to see a hematologist.  At the very least, sequential compression stocking and post operative lovanox should be considered.

History of PE and breast surgery

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as you mentioned, in many cases the cause of such embolisms is idiopathic, However, a full examination and clearance from a hematologist is necessary and if you are taking currently thinners a preoperative protocol for blood thinners might be needed.

Breast augmentation in it self is an hour procedure so it's not a lengthy surgery but given your history i would still ask for a hematologist consultation before hand

Best of luck

You can have cosmetic surgery even if you have had a past PE, with proper precautions.

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I wonder if you had a workup for clotting disorders when you were treated for your PE. There are some genetic mutations that can increase risk. A breast augmentation is a short procedure and may be done under total intravenous anesthesia, avoiding muscle relaxation (we don't want any venous blood pooling in your legs). At our facility you would be treated with this type of anesthesia, which I call SAFE anesthesia (spontaneous breathing, avoid gas, face up, extremities mobile).  My practice is to perform Doppler ultrasound scans on your legs before surgery, the day after surgery, and 1 week after surgery. That way any blood clots that start to develop can be detected early, while they are still small and easily treated. We would discuss whether to also use an anticoagulant simultaneously. So there are safe ways to have your surgery.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Breast augmentation after PE

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Lucky you survived that. Yes you can have breast augmentation after a PE. I would have a hemotologist rule out any clotting disorder first. Birth control pills do cause DVT and possible PE. In my hands, I don't think a half hour procedure would be too risky for a recurrent DVT but Lovenox may be a safer way to go to insure no clotting in leg veins. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

PE Survivor

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Scary story, I'm glad your recovered well from that. Your hematologist is a great resource for any suggestions about pre op meds such as Lovenox, which we often give before certain surgeries. Breast  implant surgery is usually rather short and a lower risk for blood clots.  Also make sure to walk every few hours after surgery to help with blood flow 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 66 reviews

Pulmonary embolism history and future surgery

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Hello, I am happy you survived this life threatening event. First of all I would see the hematologist ASAP. While it is possible the PE was related to the pill, you could have an underlying clotting abnormality. 
There are things that can be done during and after surgery to mitigate the risks of another PE, such as pumps on the legs and drugs like lovenox, but one has to wait a certain period of time to start that drug. Also walking after the surgery is important. I hope this works out for you.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 32 reviews

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